NPI age
14 years
Enumerated 2011-09-13
● Active Type 2 · Organization
Wellstreet Of Georgia Pc
Wellstreet Of Georgia Pc is 1 of 354 clinic/center organizations in Georgia.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Ellison
Vice President Revenue Cycle Manage
Last NPPES update
2025-11-05
Source: monthly bulk 2026-05
How this organization compares
Across 354 active clinic/center providers in Georgia.
NPI age
14 years
↑ 4 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2011 → 2026
2011-09Enumerated in NPPES
2011
2026
Where they practice
Primary practice location
1825 Highway 34 E Ste 1200
Newnan, GA 302656416
Mailing address
3350 Riverwood Pkwy Se Ste 1850
Atlanta, GA 303393300
Authorized official
Victoria Ellison
Vice President Revenue Cycle Manage
📞 7705022121
Individual providers at this organization
10 individual providers on file at this primary practice address.
- Elizabeth Burson Physician Assistant NPI 1780467613
- Brandon Cook, PA-C Physician Assistant NPI 1225680168
- Michael Duchynski, M.D. Emergency Medicine NPI 1346325479
- Gabrielle Galon, PA-C Physician Assistant NPI 1013415066
- Ngozi Ikeme, SOLE PROPRIETOR Registered Nurse NPI 1952934465
- Andrew Maas, PA-C Physician Assistant NPI 1376272682
- Deidre Parmley, P.A. Physician Assistant NPI 1952535239
- Prital Patel, PA-C Physician Assistant NPI 1083215214
- Alexis Rook, PA-C Physician Assistant NPI 1124503933
- June Tibaleka, MD Emergency Medicine NPI 1891115465
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003137211A |
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
WellStreet Urgent Care
-
WellStreet Urgent Care
Practice context
Multi-provider organization. 10 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.